Older children may have accidents if they are sick.
Healthy kids also have accidents.
If this happens a lot, it is called:

• Enuresis - wetting accidents, or
  
  
• Encopresis - bowel movement accidents.

Encopresis (en-ko-PRE-sis) : Accidental bowel movements (poop).

Eneuresis (en-you-REE-sis) : Accidental wettings (pee).

What causes encopresis?

Potty training teaches children to use the toilet.

They learn how their body feels when it is time to go to the bathroom.

But sometimes they can’t feel the signals. They can’t tell when it is time to use the toilet.

Encopresis isn't a problem "in a child's head." It isn't a "behavior problem."

Encopresis happens because a child's colon doesn't work the way it should.

Sometimes a child doesn’t go to the bathroom regularly.
The colon is never empty.

The bowel movement, or feces, fill the colon.
They get hard and dry.
Going to the bathroom can hurt.

The colon and rectum stretch.
This can hurt the nerves.
It can hurt the muscles.
Then the colon can’t signal the brain that it is time to go to the bathroom.

Wet feces can leak out.
They get past the hard, dry stool.
They stain a child’s clothes.

BM or bowel movement: Passing feces.

Feces (FEE-sees):The solid waste when you go to the bathroom.

How can I tell if my child has encopresis?

Some signs of encopresis are:

• You child often has BM accidents and stained underwear.
• Your child complains about clothes being too tight around the waist.
• You can feel a hard mass at one side of your child's stomach.
  Or you can feel a mass that goes around the outside of your child's stomach, like a big, upside-down U.
• Your child says it hurts to have a bowel movement.
• Your child is often too full to eat, or vomits after eating.
• Your child complains of stomachache, heartburn, or cramps.

Why worry about encopresis?

Encopresis can lead to other problems. It can cause:

Megacolon.
The colon gets bigger and bigger. This hurts the colon's muscles and nerves. Then they can’t signal it’s time for a bowel movement.

Megacolon (MEG-uh-CO-lun) : The colon gets too big.

Fissures.
The skin around the rectum can crack and bleed. The cracks are called fissures. They hurt.

Bladder infection.
The big colon can press on your child’s bladder. It can keep the bladder from emptying. When urine stays in the bladder, it can cause infection.

Bladder: Where urine is stored.

Urine (YOU-rin) : The wet waste when you go to the bathroom.

You can often cure encopresis.

To do this, you need to:

Be patient. It takes time to cure encopresis. You need to be patient. Your child needs to be patient.

Praise your child. Don’t tease your child about BM accidents. Instead, praise your child each time they go to the bathroom on schedule.

Treat encopresis with:

• Patience.
• Praise.
• Enemas.
• Laxatives.
• Fiber.
• Fluid.
• Exercise.
• Bathroom routine.
• Valsalva maneuver.

Use laxatives. Laxatives make it easier to have a bowel movement. They make the feces softer. They help your child have a regular BM.

Don't worry about your child becoming "addicted" to laxatives. This won't happen. Using laxatives helps clean out the BM. It also helps the colon heal.

Laxatives (LACKS-uh-tiv) : Make having a BM easier. They are taken by mouth.

Use an enema. Your nurse will show you how to use an enema. Using an enema cleans out the colon and rectum.

Fiber, fluids, exercise!
Your child needs lots of:

High fiber foods, like fresh vegetables and fruits.

Fluids, all day long.

Exercise.

Fiber: The parts of grains, vegetables, and fruits that aren’t digested.

Fluids: Drinks, like water, juice, milk.

Exercise: Using muscles to make them strong. For example, walking, jogging, playing ball.

Have a bathroom routine.
Your child should try to have a BM after each meal, and again at bedtime.

• Your child should try to go to the bathroom after each meal -- even at school. When your child eats, the intestines squeeze. This moves the food along. It also makes it easier to have a BM.
  
  
• Your child should also go to the bathroom at bedtime.

Keep track of when your child has a bowel movement. Write down whether you used laxatives or suppositories. Put down when they were given:

Day, date	Suppository [S] Laxative [L] given at (time)	BM at (time)	Place
Sat, Nov 12	L - 7 AM	10:30 AM	Home
Sun, Nov 13	L - 7:00 AM S - 4:30 PM	5 PM	Home
Mon, Nov 14	L - 7 AM	8:30 AM	School

Routine: Doing the same thing at the same time each day.

Intestines: The long tube in the gut where food is digested.

Suppositories are put into the rectum. They help a child have a bowel movement.

Teach your child the Valsalva maneuver.
This can help your child go to the bathroom. Have your child:

• Hold her breath.
  
  
• Squeeze in her stomach muscles.
  
  
• Push hard, to have a BM.

How long does it take to cure encopresis?

Curing encopresis takes about 6 to 12 months. It involves learning new habits. Patience is important.

Keep encopresis from coming back!

Every day, make sure your child has the BIG FOUR:

1. Fiber.
2. Fluids.
3. Exercise.
4. Bathroom routine.

Please note -- Before using this information, please talk about it with your family doctor or other health care provider.

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